Efficacy and safety of quinolones as potential first line therapy in pulmonary tuberculosis: a meta-analysis

Introduction: Tuberculosis is an infectious disease that continues to plague the world today, causing concerns due to its high mortality rate. The therapy regimens used for the treatment of tuberculosis today have demonstrated high efficacy and safety, potentially reducing the disease’s burden, but the use of some standardized medications has caused many resistances to emerge. Over the last decade, researchers have been looking for suitable alternatives, with quinolones emerging as the most promising candidate due to their efficacy, safety, and availability. However, their efficacy as a first-line treatment remains debatable. Aim: This study is focused on assessing the efficacy and safety of quinolone therapy combined with other regimens for pulmonary TB first-line treatment. Materials and methods: Literature search was conducted in the databases of Cochrane, PubMed, ScienceDirect, and Google Scholar using the Boolean keywords of “tuberculosis”, “treatment”, and “quinolone”. Statistical analyses were performed using ReviewManager 5.4.1 and shown as forest plots of odds ratios. Results: We analyzed 13 studies in this study. There were no significant differences between the study group and controls in the conversion rate ≤8 weeks (p=0.07, 95% CI 0.9–13.01), the success rate (p=0.80, 95% CI 0.57–1.54), adverse events (p=0.13, 95% CI 0.91–2.13), mortality rate (p=0.25, 95% CI 0.68–1.11), and recurrence rate (p=0.39, 95% CI [0.74–2.12]) . Conclusions: According to the forest plot analysis, each of the results is non-significant. This concludes that the efficacy and safety of quinolone tended to be used as the second-line of choice of pulmonary tuberculosis treatment compared to the control group